Outcomes benchmarking support packs: LA level Essex Local Authority Produced with input from: Public Health England
Forward and Introduction................................................................ 3........ Summary spider diagram and spine chart................................................... 4........ Section 1: Background information Contents Population profile.................................................................. 7........ Deprivation map................................................................... 8........ Section 2: NHS Outcomes Framework: overarching indicators 1a Potential years of life lost (PYLL) from causes considered amenable to healthcare............ 10......... 1bi Life expectancy at age 75 (Males).................................................. 11......... 1bii Life expectancy at age 75 (Females)............................................... 12......... 2 Health-related quality of life for people with long term conditions............................ 13......... 3a Emergency admissions for acute conditions that should not usually require hospital admission........................................................... 14......... 3b Emergency readmissions within 30 days of discharge from hospital........................ 15......... 4ai Patient experience of GP services................................................. 16......... 4aii Patient experience of GP out-of-hours services....................................... 17......... 4aiii Patient experience of dental services.............................................. 18......... 4b Patient experience of hospital care................................................. 19......... Section 3: Public Health Outcomes Framework: overarching indicators 0.1 Healthy life expectancy.......................................................... 21......... 0.2 Differences in life expectancy between communities................................... 23......... Section 4: Adult Social Care Outcomes Framework: overarching indicators 1A Social care-related quality of life................................................... 25......... 2A Permanent admissions to residential and nursing care homes............................ 26......... 3A Overall satisfaction of people who use services with their care and support.................. 28......... 4A Proportion of people who use services who feel safe................................... 29......... Section 5: Main CCGs for this LA's residents.............................................. 30......... Sources and references................................................................ 32......... Page Page 2
Forward and Introduction Local decision making is at the heart of the NHS, and the NHS Commissioning Board, Public Health England and the Local Government Association are committed to providing high quality comparable intelligence to support clinical commissioning groups (CCGs) and health and wellbeing boards (HWBs) identify local priorities and agree local plans. Alongside the publication of the NHS Commissioning Board s 2013-14 Planning Guidance, we have produced initial information packs at Local Authority and CCG level that set out key data to inform the local position on outcomes. The Local Authority level packs present high level comparative information on the NHS, the Adult Social Care and the Public Health Frameworks. The CCG level packs provide a more detailed analysis of NHS outcomes and other relevant indicators. The purpose of these is to provide CCGs and HWB partners with a quick and easy-to-use summary of their current position on outcomes as they take up their role, building on the data sets in the CCG outcomes indicators and other existing data sets. The information should be used alongside the local intelligence that is being collected to inform local Joint Strategic Needs Assessments and it will support commissioners working together to set the priorities for the Joint Health and Wellbeing Strategy. Where possible we have signposted other relevant information sources that might help build an understanding of the specific issues locally. These information packs represent a starting point for the way the NHS CB will provide support in this area going forward and we hope you find them useful. We would like to offer you an open invitation to work co-productively with us on an on-going basis to help shape these tools in a way that would be most helpful for you locally. If you have any comments or suggestions for improvement please email nhscb.outcomes-benchmarking@nhs.net. Page 3
Essex summary spider diagram (shows one indicator per domain) 1a PYLL from causes amenable to healthcare 0.2iii Differences in life expectancy 2 Health related quality of life for people with LTCs 0.1i Proxy for healthy life expectancy 3a Avoidable emergency admissions 4A % of service users who feel safe 4ai Patient experience (GPs) 3A Overall satisfaction with care and support 1A Social carerelated quality of life 2A(2) Permanent admissions to care homes (65+) This LA is in the Prospering UK ONS cluster Each 'leg' of the chart represents a high-level indicator from the three Outcomes Frameworks. Each 'leg' is orientated such that points further from the origin represent "better" performance. Where there is more than one indicator for an Outcome Framework domain, a single indicator is shown in this chart. The coloured spots show this LA's rank within all LAs in England. The grey circle represents the England median and the yellow shape represents the ONS cluster median. The equal spacing of the indicators in the diagram is not meant to suggest any implied weighting or relative importance of the different indicators or Outcomes Frameworks. Page 4
Essex spine chart (shows all overarching indicators) The chart below shows the distribution of the LAs on each indicator in terms of ranks. This LA is shown as a red diamond. The yellow box shows the interquartile range and median of LAs in the same ONS cluster as this LA. Each indicator has been orientated so that better outcomes are towards the right (light blue). This chart supports the spider chart by providing a single page summary of all the available overarching indicators. Outcome Indicator 1a Potential years of life lost (PYLL) from causes considered amenable to healthcare 1bi Life expectancy at age 75 (Males) 1bii Life expectancy at age 75 (Females) 2 Health-related quality of life for people with long term conditions 3a Emergency admissions for acute conditions that should not usually require hospital admission 3b Emergency readmissions within 30 days of discharge from hospital 4ai Patient experience of GP services 4aii Patient experience of GP out-of-hours services 4aiii Patient experience of dental services 0.1i Proxy for healthy life expectancy a birth using Disablility Free Life Expectancy (DFLE) at age 16 0.2ii Life expectancy at birth 0.2iii Slope Index of Inequality in life expectancy at birth [proxy dataset] 1A Social care-related quality of life This LA is in the Prospering UK cluster 2A(1) Permanent admissions to residential and nursing care homes (age 18-64) 2A(2) Permanent admissions to residential and nursing care homes (age 64+) 3A Overall satisfaction of people who use services with their care and support 4A Proportion of people who use services who feel safe LA and cluster distribution (LAs ranked; right = better outcomes) Worse Better Page 5
SECTION 1 Background Information Page 6
Population profile (2011 census) The chart below shows the number of people in this Local Authority by sex and 5-year age band. The darker outlines show the profile of the England population. 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 56,000 42,000 28,000 14,000 0 0 14,000 28,000 42,000 56,000 Females Males The table below shows summary population numbers for this Local Authority and also how it is expected to grow by 2015 and 2020. The growth rates are shown as annualised percentages and the projected England growth rate is shown for comparison. Under 15 15-44 45-64 65-75 75-84 85+ All ages Age 2011 population 2015 population 2011-15 p.a. growth 2020 population 2015-20 p.a. growth This LA This LA This LA England This LA This LA England 242,554 256,053 1.4% 1.2% 278,176 1.7% 1.4% 518,480 519,079 0.0% 0.2% 525,720 0.3% 0.2% 377,388 383,934 0.4% 0.6% 399,755 0.8% 0.7% 135,023 158,505 4.1% 3.4% 166,262 1.0% 1.0% 87,594 94,135 1.8% 1.6% 106,738 2.5% 2.3% 35,560 41,616 4.0% 3.1% 50,361 3.9% 3.4% 1,396,599 1,453,321 1.0% 0.9% 1,527,013 1.0% 0.8% Page 7
Deprivation map The map below shows the levels of deprivation in and around this LA, based on the Index of Multiple Deprivation 2010 (IMD2010). The IMD2010 is calculated at Lower Super Output Area (LSOA) level. However, in this map we have given each postcode within the same LSOA the same colour, rather than shade the entire LSOA area. This presentation emphasizes where people live rather than open countryside. Page 8
SECTION 2 NHS Outcomes Framework Indicators Page 9
NHS OF 1a Potential Years of Life Lost (PYLL) from causes considered amenable to healthcare Age/sex standardised rate per 100,000 population Darker shades = More years lost Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LA in the same ONS 4,000 3,500 3,000 2,500 2,000 1,928 1,500 1,000 500 0 Page 10
NHS OF 1b(i) Life expectancy at age 75 (Males) Number of additional years men age 75 are expected to live Darker shades = Lower Life expectancy Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LA in the same ONS 20.0 18.0 16.0 14.0 12.0 11.4 10.0 8.0 6.0 4.0 2.0 0.0 Page 11
NHS OF 1b(ii) Life expectancy at age 75 (Females) Number of additional years women age 75 are expected to live Darker shades = Lower Life expectancy Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LAs in the same ONS 20.0 18.0 16.0 14.0 13.3 12.0 10.0 8.0 6.0 4.0 2.0 0.0 Page 12
NHS OF 2 Health-related quality of life for people with long term conditions Average EQ-5D index for people who reported having an LTCs in the GP Patient Survey Darker shades = Lower quality of life Source: GP Patient Survey. This indicator has not been age-sex standardised or adjusted for disease prevalence. This LA is shown in red. Yellow bars represent other LAs in the same ONS 0.9 0.8 0.74 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0.0 Page 13
NHS OF 3a Emergency admissions for acute conditions that should not normally require hospital admission Indirectly age/sex standardised rate per 100,000 population Darker shades = Higher rate of admissions Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LAs in the same ONS 2,000 1,800 1,600 1,400 1,200 1,000 891 800 600 400 200 0 Page 14
NHS OF 3b Emergency readmissions with 30 days of discharge from hospital Percentage rate, standardised for age, sex, method of admission and diagnosis/procedure Darker shades = Higher rate of admissions Source: NHS Information Centre Indicator Portal This LA is shown in red. Yellow bars represent other LAs in the same ONS 16% 14% 12% 10.6% 10% 8% 6% 4% 2% 0% Page 15
NHS OF 4a(i) Patient experience of primary care (GP services) % of people who rate their experience of their GP surgery as "very good" or "fairly good" Darker shades = Worse experience Source: GP Patient Survey; provisional analysis. This indicator is not age/sex standardised but survey responses are weighted for non-response. This LA is shown in red. Yellow bars represent other LAs in the same ONS 100% 90% 88% 80% 70% 60% 50% 40% 30% 20% 10% 0% Page 16
NHS OF 4a(ii) Patient experience of primary care (Out of Hours Services) % of people who rate their experience of out-of-hours services as "very good" or "fairly good" Darker shades = Worse experience Source: GP Patient Survey; provisional analysis. This indicator is not age/sex standardised but survey responses are weighted for non-response. This LA is shown in red. Yellow bars represent other LAs in the same ONS 100% 90% 80% 70% 72% 60% 50% 40% 30% 20% 10% 0% Page 17
NHS OF 4a(iii) Patient experience of primary care (Dentistry) % of people who rate their experience of dentistry services as "very good" or "fairly good" Darker shades = Worse experience Source: GP Patient Survey; provisional analysis. This indicator is not age/sex standardised but survey responses are weighted for non-response. This LA is shown in red. Yellow bars represent other LAs in the same ONS 100% 90% 85% 80% 70% 60% 50% 40% 30% 20% 10% 0% Page 18
NHS OF 4b Patient experience of hospital care Composite experience scores (out of 100) at this LA's main 5 providers The table below shows the composite score based on people who reported that their experience was "very good" or "fairly good" in various patient surveys. Note that these scores refer to all patients surveyed at the providers and do not refer specifically to this LA's patients. To give additional context, this page includes additional indicators 4.1-4.3 from the NHS Outcomes Framework. Providers (ordered by number of admissions) for this LA's residents Number of Admissions / spells (Acute 2010/11) 4b Inpatient Overall Experience 4.1 Outpatient Overall Experience 4.2 Inpatient Responsiveness to needs 4.3 A&E Overall Experience 1 Mid Essex Hospital Services NHS Trust 24,816 R Q 75 80 67 77 2 Colchester Hospital Univ NHS FT 23,254 R D 76 79 67 78 3 Basildon & Thurrock Univ Hospitals NHS FT 14,373 R D 75 79 67 78 4 The Princess Alexandra Hospital NHS Trust 12,406 R Q 70 76 60 79 5 Southend Univ Hospital NHS FT 12,232 R A 75 77 66 80 LA weighted average 74 79 66 78 England Average 76 80 67 80 100 90 80 70 60 LA weighted average England average This LA's providers 50 40 30 20 10 0 4b Inpatient Overall Experience 4.1 Outpatient Overall Experience 4.2 Inpatient Responsiveness to needs 4.3 A&E Overall Experience Page 19
SECTION 3 Public Health Outcomes Framework Indicators Page 20
PH OF 0.1i Proxy for healthy life expectancy at birth Disability Free Life Expectancy (DLFE) at age 16 for males and females combined Darker shades = Lower disability free life expectancy This is a proxy dataset as data for healthy life expectancy at birth is not yet available at LA level Source: ONS This LA is shown in red. Yellow bars represent other LAs in the same ONS 60 50 52 40 30 20 10 0 Page 21
PH OF 0.1ii Life expectancy at birth Life expectancy at birth for males and females combined Darker shades = Lower life expectancy Source: ONS This LA is shown in red. Yellow bars represent other LAs in the same ONS 100 90 80 82 70 60 50 40 30 20 10 0 Page 22
PH OF 0.2iii Slope Index of Inequality in life expectancy at birth Slope Index of Inequality (SII) in life expectancy for males and females combined Darker shades = Greater inequality This is a proxy indicator as data using the final methodology for this indicator is not yet available. Source: Health Observatory This LA is shown in red. Yellow bars represent other LAs in the same ONS 14 12 10 8 6 6.1 4 2 0 Page 23
SECTION 4 Adult Social Care Outcomes Framework Indicators Page 24
Adult Social Care OF 1A Social care-related quality of life Average quality of life score based on responses to the Adult Social Care Survey Darker shades = Lower quality of life Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LAs in the same ONS 20.0 18.9 15.0 10.0 5.0 0.0 Page 25
Adult Social Care OF 2A(1) Permanent admissions to residential and nursing care homes for people age 18-64 Rates per 100,000 population age 18-64 Darker shades = Higher admissions rate Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LAs in the same ONS 80 70 60 50 40 30 20 18 10 0 Page 26
Adult Social Care OF 2A(2) Permanent admissions to residential and nursing care homes for people age 65+ Rates per 100,000 population age 65+ Darker shades = Higher admissions rate Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LAs in the same ONS 1,400 1,200 1,000 800 661 600 400 200 0 Page 27
Adult Social Care OF 3A Overall satisfaction of people who use services with their care and support % of people who rate their satisfaction as "very" or "extremely" satisfied Darker shades = Lower % satisfied Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LAs in the same ONS 100% 90% 80% 70% 60% 60% 50% 40% 30% 20% 10% 0% Page 28
Adult Social Care OF 4A Proportion of people who use services who feel safe % of people who say they "feel as safe as they want" Darker shades = Lower % who feel safe Source: Health and Social Care Information Centre This LA is shown in red. Yellow bars represent other LAs in the same ONS 100% 90% 80% 70% 70% 60% 50% 40% 30% 20% 10% 0% Page 29
SECTION 5 Main CCGs for this LA's residents Page 30
5000 22 CCGs of GP Practice registration for this LA's residents CCGs (ordered by number of residents in this LA) NHS Mid Essex CCG 1 NHS North East Essex 2 CCG NHS West Essex CCG 3 NHS Basildon and 4 Brentwood CCG NHS Castle Point, 5 Rayleigh and Rochford NHS East and North 6 Hertfordshire CCG NHS Redbridge CCG 7 NHS Southend CCG 8 NHS West Suffolk CCG 9 Number of People 379,401 323,507 283,848 261,482 171,022 11,427 9,061 8,926 5,733 Unknown (Special lists) 10 2,577 Others 6,263 10 Total 1,463,246 The first table shows the CCG(s) that this LA's residents are registered with. The tables below then show which other LAs these CCGs' registered patients live in. (Up to 4 CCGs are shown.) 3 4 6 7 9 10 12 13 4 3 9 4 06Q 06T 07H 99E 9 NHS Mid Essex CCG No. of People NHS North East Essex CCG No. of People NHS West Essex CCG No. of People NHS Basildon and Brentwood CCG No. of People 06Q Essex 379,401 Essex 323,507 Essex 283,848 Essex 261,482 06T Suffolk 70 Suffolk 4,242 Redbridge 5,043 Thurrock 371 07H Southend-on-Sea 6 Thurrock 5 Hertfordshire 2,136 Southend-on-Sea 58 99E Thurrock 6 Cambridgeshire 726 Havering 36 99F Suffolk 262 06K Waltham Forest 123 08N Havering 99 99G Enfield 4 07K NA Barking and Dagenham Other 0 Other 0 Other 0 Other 0 Total 379,483 Total 327,754 Total 292,246 Total 261,947 Source: Attribution Data Set, April 2012 4 Page 31
Sources and references Populations Source: ONS. Data are from the 2011 census. Deprivation Source: Indices of Multiple Deprivation. Data are from the 2010 Index. The centroid of residential postcodes within each LSOA are shaded. NHS 1a Source: Health and Social Care Information Centre. Data are 2010. Directly age standardised rates per 100,000 population. NHS 1bi, 1bii Source: Health and Social Care Information Centre. Data are 2008-10 combined. NHS 2 Source: GP Patient Survey. Data are July 2011 - March 2012. This indicator is not standardised for age/sex but survey responses are weighted for non-response. Based on LA of residence of survey respondents. NHS 3a Source: Health and Social Care Information Centre. Data are 2011/12. Indirectly age/sex standardised rate. NHS 3b Source: Health and Social Care Information Centre. Data are 2010/11. Percentage indirectly standardised for age, sex, method of admission and diagnosis/procedure; admissions for cancer/obstetrics are excluded. NHS 4ai, 4aii, 4aiii Source: GP Patient Survey; interim analysis by Commissioning Board analysis team. Data for 4ai and 4aii are July 2011 - March 2012; 4aiii is July - September 2011. This indicator is not standardised for age/sex but survey responses are weighted for non-response. Based on LA of residence of survey respondents. NHS 4b Source: Inpatient Survey / Health and Social Care Information Centre. Data are 2011. Composite indicator of 5 domains in the survey. PH 0.1i, 0.1ii Source: ONS. DLFE data are 2007-9 and life expectancy data are 2008-10. Unweighted average of published figures for males and females. 0.1i is a proxy indicator as data using the final methodology for this indicator is not yet available. PH 0.2iii Source: Health Observatory. Data are 2006-10. Average of published figures for males and females. This is a proxy indicator as data using the final methodology for this indicator is not yet available. SC 1A Source: Health and Social Care Information Centre. Data are 2011/12. Survey responses are weighted for nonresponse. SC 2A Source: Health and Social Care Information Centre. Data are 2011/12. SC 3A Source: Health and Social Care Information Centre. Data are 2011/12. Survey responses are weighted for nonresponse. SC 4A Source: Health and Social Care Information Centre. Data are 2011/12. Survey responses are weighted for nonresponse. Main CCGs Source: Attribution Data Set. Data are for April 2012. Additional Resources Information Centre Indicator Portal PH Outcomes Framework Tool National General Practice Profiles Spend and Outcomes Tool (SPOT) Quality and Outcomes Framework database LA Health Profiles Health Investment Network NHS Comparators http://indicators.ic.nhs.uk http://www.phoutcomes.info http://www.apho.org.uk/pracprof http://www.yhpho.org.uk/spot http://www.qof.ic.nhs.uk http://www.apho.org.uk/default.aspx?qn=p_health_profiles http://www.networks.nhs.uk/nhs-networks/health-investment-network http://www.nhscomparators.nhs.uk Crown copyright 2012 Contains National Statistics data Crown copyright and database right 2012 Email: nhscb.outcomes-benchmarking@nhs.uk